ABSTRACT
ABSTRACT Introduction: Double-J stent insertion during laparoscopic pyeloplasty is a difficult and time-consuming process and several techniques were defined to perform a double-J stent with an antegrade approach. In this study we present the technique (PICA) of antegrade double-J placement during laparoscopic pyeloplasty by using 14 gauge intravenous cannula. Surgıcal technıque: After we complete the suturing of the posterior wall of the anastomosis during laparoscopic pyeloplasty, we first puncture the abdominal wall with a 14-gauge "intravenous cannula" from a location that provides most suitable angle for inserting the double-J stent into the ureter. We remove the metal needle of the cannula, and the sheath which has an inner diameter of 5.2F remains over the abdominal wall. The double J stent is then advanced from inside the cannula sheath to the intraperitoneal area; under laparoscopic imaging the stent is gently grasped at its distal end using an atraumatic laparoscopic forceps to insert it into the ureter. The stent is then pulled down to its proximal end, and after the guidewire is removed, the proximal end of the double-J stent is placed inside the renal pelvis with an atraumatic forceps. With this technique we can apply the double-J stent in just one step. Additionaly we can use a 14-gauge IV cannula sheath as a trocar when needed during laparoscopic pyeloplasty to retract an organ or reveal an anastomosis line. Comments: Our new technique of antegrade double-J placement during laparoscopic pyeloplasty by 14 gauge intravenous cannula sheath, is very easy and quick to perform.
Subject(s)
Humans , Stents , Laparoscopy/methods , Cannula , Urologic Surgical Procedures/instrumentation , Urologic Surgical Procedures/methodsABSTRACT
AIM: Varicocele is characterized by abnormal tortuosity and dilatation of the veins of the pampiniform plexus within the spermatic cord and is one of the causes related to male infertility. This study aimed to investigate the correlation between varicocele and somatometric parameters. We also aimed to determine prevalence and treatment ratio of this disorder among healthy young Turkish men. MATERIALS AND METHODS: A total of 2061 young men aged from 19 to 34 years was enrolled and cross sectionally evaluated for status of varicocele. Body mass index was calculated. Patients were categorized as normal weight, overweight and obese using by National Institutes of Health criteria. Patients underwent physical examinations for the presence and grade of varicocele. If the varicocele was found and previously submitted to different treatment modalities, the age of treatment and outcomes were recorded. RESULTS: Varicocele was present in 498 men (24.2%). The mean age of the participants was 22.7 ± 1.8 years, and the median BMI was 22.8 ± 2.0 kg/m². There were no significant differences in age, height, weight and BMI among the patients with different grades of varicocele (p > 0.05). Although no significant difference was found in varicocele prevalence between normal weight and over-weight participants (p > 0.05), obese participants had significantly lower varicocele prevalence compared with normal or over weight participants (p = 0.006). A total of 49 men had scrotal pain and the treatment ratio was only 2.8%. CONCLUSION: Prevalence of varicocele was found in about 24% of healthy young Turkish population. Participants with varicocele had significantly lower BMI values compared with those without varicocele. Our findings supported the hypothesis that individuals with a greater BMI may have advantages in relieving the varicocele, but further studies are required to clarify this issue. Additionally treatment ratio was low among young men with varicocele.